Open-door laminoplasty for cervical myelopathy resulting from adjacent-segment disease in patients with previous anterior cervical decompression and fusion

Morio Matsumoto, Kenya Nojiri, Kazuhiro Chiba, Yoshiaki Toyama, Yasuyuki Fukui, Michihiro Kamata

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

STUDY DESIGN.: This is a retrospective study of patients with cervical myelopathy resulting from adjacent-segment disease who were treated by open-door expansive laminoplasty. OBJECTIVES.: The purpose of this study was to evaluate the effectiveness of laminoplasty for cervical myelopathy resulting from adjacent-segment disease. SUMMARY OF BACKGROUND DATA.: Adjacent-segment disease is one of the problems associated with anterior cervical decompression and fusion. However, the optimal surgical management strategy is still controversial. METHODS.: Thirty-one patients who underwent open-door expansive laminoplasty for cervical myelopathy resulting from adjacent-segment disease and age- and sex-matched 31 patients with myelopathy who underwent laminoplasty as the initial surgery were enrolled in the study. The pre- and postoperative Japanese Orthopedic Association scores (JOA scores) and the recovery rate were compared between the two groups. RESULTS.: The average JOA scores in the patients with adjacent-segment disease and the controls were 9.2 ± 2.6 and 9.4 ± 2.3 before the expansive laminoplasty and 11.9 ± 2.8 and 13.3 ± 1.7 at the follow-up examination, respectively; the average recovery rates in the two groups were 37.1 ± 22.4% and 50.0 ± 21.3%, respectively (P = 0.04). The mean number of segments covered by the high-intensity lesions on the T2-weighted magnetic resonance images was 1.87 and 0.9, respectively (P = 0.001). CONCLUSIONS.: Moderate neurologic recovery was obtained after open-door laminoplasty in patients with cervical myelopathy resulting from adjacent-segment disc disease, although the results were not as satisfactory as those in the control group. This may be attributed to the irreversible damage of the spinal cord caused by persistent compression at the adjacent segments.

Original languageEnglish
Pages (from-to)1332-1337
Number of pages6
JournalSpine
Volume31
Issue number12
DOIs
Publication statusPublished - 2006 May

Fingerprint

Spinal Cord Diseases
Decompression
Orthopedics
Nervous System
Laminoplasty
Spinal Cord
Magnetic Resonance Spectroscopy
Retrospective Studies
Control Groups

Keywords

  • Adjacent-segment disease
  • Anterior cervical decompression and fusion
  • Cervical myelopathy
  • Open-door expansive laminoplasty

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Open-door laminoplasty for cervical myelopathy resulting from adjacent-segment disease in patients with previous anterior cervical decompression and fusion. / Matsumoto, Morio; Nojiri, Kenya; Chiba, Kazuhiro; Toyama, Yoshiaki; Fukui, Yasuyuki; Kamata, Michihiro.

In: Spine, Vol. 31, No. 12, 05.2006, p. 1332-1337.

Research output: Contribution to journalArticle

Matsumoto, Morio ; Nojiri, Kenya ; Chiba, Kazuhiro ; Toyama, Yoshiaki ; Fukui, Yasuyuki ; Kamata, Michihiro. / Open-door laminoplasty for cervical myelopathy resulting from adjacent-segment disease in patients with previous anterior cervical decompression and fusion. In: Spine. 2006 ; Vol. 31, No. 12. pp. 1332-1337.
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abstract = "STUDY DESIGN.: This is a retrospective study of patients with cervical myelopathy resulting from adjacent-segment disease who were treated by open-door expansive laminoplasty. OBJECTIVES.: The purpose of this study was to evaluate the effectiveness of laminoplasty for cervical myelopathy resulting from adjacent-segment disease. SUMMARY OF BACKGROUND DATA.: Adjacent-segment disease is one of the problems associated with anterior cervical decompression and fusion. However, the optimal surgical management strategy is still controversial. METHODS.: Thirty-one patients who underwent open-door expansive laminoplasty for cervical myelopathy resulting from adjacent-segment disease and age- and sex-matched 31 patients with myelopathy who underwent laminoplasty as the initial surgery were enrolled in the study. The pre- and postoperative Japanese Orthopedic Association scores (JOA scores) and the recovery rate were compared between the two groups. RESULTS.: The average JOA scores in the patients with adjacent-segment disease and the controls were 9.2 ± 2.6 and 9.4 ± 2.3 before the expansive laminoplasty and 11.9 ± 2.8 and 13.3 ± 1.7 at the follow-up examination, respectively; the average recovery rates in the two groups were 37.1 ± 22.4{\%} and 50.0 ± 21.3{\%}, respectively (P = 0.04). The mean number of segments covered by the high-intensity lesions on the T2-weighted magnetic resonance images was 1.87 and 0.9, respectively (P = 0.001). CONCLUSIONS.: Moderate neurologic recovery was obtained after open-door laminoplasty in patients with cervical myelopathy resulting from adjacent-segment disc disease, although the results were not as satisfactory as those in the control group. This may be attributed to the irreversible damage of the spinal cord caused by persistent compression at the adjacent segments.",
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T1 - Open-door laminoplasty for cervical myelopathy resulting from adjacent-segment disease in patients with previous anterior cervical decompression and fusion

AU - Matsumoto, Morio

AU - Nojiri, Kenya

AU - Chiba, Kazuhiro

AU - Toyama, Yoshiaki

AU - Fukui, Yasuyuki

AU - Kamata, Michihiro

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N2 - STUDY DESIGN.: This is a retrospective study of patients with cervical myelopathy resulting from adjacent-segment disease who were treated by open-door expansive laminoplasty. OBJECTIVES.: The purpose of this study was to evaluate the effectiveness of laminoplasty for cervical myelopathy resulting from adjacent-segment disease. SUMMARY OF BACKGROUND DATA.: Adjacent-segment disease is one of the problems associated with anterior cervical decompression and fusion. However, the optimal surgical management strategy is still controversial. METHODS.: Thirty-one patients who underwent open-door expansive laminoplasty for cervical myelopathy resulting from adjacent-segment disease and age- and sex-matched 31 patients with myelopathy who underwent laminoplasty as the initial surgery were enrolled in the study. The pre- and postoperative Japanese Orthopedic Association scores (JOA scores) and the recovery rate were compared between the two groups. RESULTS.: The average JOA scores in the patients with adjacent-segment disease and the controls were 9.2 ± 2.6 and 9.4 ± 2.3 before the expansive laminoplasty and 11.9 ± 2.8 and 13.3 ± 1.7 at the follow-up examination, respectively; the average recovery rates in the two groups were 37.1 ± 22.4% and 50.0 ± 21.3%, respectively (P = 0.04). The mean number of segments covered by the high-intensity lesions on the T2-weighted magnetic resonance images was 1.87 and 0.9, respectively (P = 0.001). CONCLUSIONS.: Moderate neurologic recovery was obtained after open-door laminoplasty in patients with cervical myelopathy resulting from adjacent-segment disc disease, although the results were not as satisfactory as those in the control group. This may be attributed to the irreversible damage of the spinal cord caused by persistent compression at the adjacent segments.

AB - STUDY DESIGN.: This is a retrospective study of patients with cervical myelopathy resulting from adjacent-segment disease who were treated by open-door expansive laminoplasty. OBJECTIVES.: The purpose of this study was to evaluate the effectiveness of laminoplasty for cervical myelopathy resulting from adjacent-segment disease. SUMMARY OF BACKGROUND DATA.: Adjacent-segment disease is one of the problems associated with anterior cervical decompression and fusion. However, the optimal surgical management strategy is still controversial. METHODS.: Thirty-one patients who underwent open-door expansive laminoplasty for cervical myelopathy resulting from adjacent-segment disease and age- and sex-matched 31 patients with myelopathy who underwent laminoplasty as the initial surgery were enrolled in the study. The pre- and postoperative Japanese Orthopedic Association scores (JOA scores) and the recovery rate were compared between the two groups. RESULTS.: The average JOA scores in the patients with adjacent-segment disease and the controls were 9.2 ± 2.6 and 9.4 ± 2.3 before the expansive laminoplasty and 11.9 ± 2.8 and 13.3 ± 1.7 at the follow-up examination, respectively; the average recovery rates in the two groups were 37.1 ± 22.4% and 50.0 ± 21.3%, respectively (P = 0.04). The mean number of segments covered by the high-intensity lesions on the T2-weighted magnetic resonance images was 1.87 and 0.9, respectively (P = 0.001). CONCLUSIONS.: Moderate neurologic recovery was obtained after open-door laminoplasty in patients with cervical myelopathy resulting from adjacent-segment disc disease, although the results were not as satisfactory as those in the control group. This may be attributed to the irreversible damage of the spinal cord caused by persistent compression at the adjacent segments.

KW - Adjacent-segment disease

KW - Anterior cervical decompression and fusion

KW - Cervical myelopathy

KW - Open-door expansive laminoplasty

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